Obesity in Children

What parents should do -- and not do -- to meet the challenge.

The incidence of obesity in children is increasing rapidly. According to recent studies, 20% of American children aged six to eleven are significantly overweight. While there are no statistics available on the occurrence of childhood obesity among Jews, anecdotal evidence, combined with the fact that so much of Jewish ritual and tradition focuses on food and eating, would suggest that the incidence of childhood obesity among Jews is at least as high as that among the larger American society.

Parents of overweight children have legitimate reason for concern. In addition to a myriad of medical problems it causes later in life, obesity condemns children to social rejection and low self esteem during the most pivotal years of their psychological development.

These parents often feel overwhelmed by intense emotions, such as anxiety, frustration, shame and guilt. In order to successfully meet the challenge of obesity in children, parents need to first understand what causes this disorder and then what they can do to help their children overcome it.

WHAT CAUSES CHILDHOOD OBESITY?

There is no single factor which leads to obesity in children. It is caused by any one or combination of the following:

Biological factors. Just as with adults, hormonal imbalances in the body can cause a child either to overeat or metabolize food too slowly. In addition, some medications prescribed for children could have the undesired side effect of causing weight gain.

Parental modeling. If one or both parents are overweight, then children have a poor example being set for them 24/7. Children tend to imitate their parents. While they do not copy all of their parents' behaviors, they almost always emulate those behaviors we would most want them to avoid.

Inadequate exercise. As academic standards rise in our ever increasing competitive society, the opportunities for children to engage in physical exercise diminish. Television, video games and other passive forms of entertainment also reduce the time today's children are active. With so little exercise, even moderate overeating can result in childhood obesity.

Poor nutrition. In our fast paced world, fast food has become a staple instead of an occasional indulgence. Families with two working parents often need to rely on take-out food regularly in order to maintain their busy lifestyle. While these meals may be tasty and convenient, they also add many more calories and much less nutrition than traditional home cooked meals. In addition, the tidal wave of advertising aimed at children, stimulates their appetite for food with high sugar and fat contents.

Psychological factors. Some children use food as a tranquilizer to calm their fears and anxieties. Others use food to comfort or soothe hurt feelings from childhood abuse or trauma. Still others overeat as a way of passively defying their parents' attempts to control their behavior. Finally, some children use food to ward off depression or to suppress angry feelings that they cannot express openly.

WHAT PARENTS SHOULD NOT DO

Although they are usually well intentioned, parents often engage in misguided strategies to help their children which only backfire and make matters worse.

Take Reuven's mother, for example. She saw him piling on the pounds when he was only 11 years old. Determined to help him, she launched a program of brow beating, harping and plain old fashioned nagging to convince him to join a weight control program. Her efforts succeeded in alienating Reuven, lowering his self esteem and crushing his confidence. And he never did lose any weight. Today, 17 years later, a still much overweight Reuven looks back and identifies his mother's attitude and approach as having contributed much more to the problem than to a solution.

WHAT PARENTS CAN DO

Consult your pediatrician. The first thing you need to do is rule out any biological factors which may be contributing to your child's obesity. Only after your pediatrician has eliminated these causes as possible considerations should you look for behavioral or environmental solutions.

Set a proper example. "Do as I say; not as I do," is as ineffective in dealing with childhood obesity as with any other childhood behavioral problem. If your eating is out of control, trying to curb your child's appetite would be like driving with your food on the gas pedal and the brake at the same time. You will get nowhere fast, while wasting a lot of energy.

Help support healthy lifestyle choices. Be sure to provide plenty of healthy snacks to your child and limit the availability of unhealthy foods at home. Teach your child the basic principles of good nutrition. For example, it is not how much you eat that counts, but rather how much of which foods. In addition, encourage your child to engage in active recreation that is both fun and aerobic. Exercise should not be a burden if you hope to make it an integral part of your child's daily schedule.

Foster dietary autonomy. Weight monitoring and weight loss must become your child's responsibility and not yours. Once you care more about your child losing weight than he or she does, you have lost the war.

The way to get your child to take charge of his or her eating is by giving more choices, not less. For example, "Which salad would you like for lunch?" is much more helpful than, "Don't take another piece of bread. You've had enough already."

Focus on positives. Punishment, criticism and disapproval are the most ineffective methods of modifying childhood behavior, even though they are widely used by parents today. What is much more helpful is to positively reinforce good behavior with praise, approval and compliments. Try to catch your children making healthy choices and verbally reward them.

Comments such as, "I was so proud of you today when you took fruit for snack," or "I know it was not easy for you to turn down the dessert Grandma offered you tonight," or "I'm so happy that you took advantage of the nice weather this afternoon to ride your bike," go a long way towards supporting your child's motivation to lose weight as well as boosting his or her self esteem.

Alleviate stress. Since food is so often misused as a source of emotional comfort and soothing, try to identify and eliminate as many sources of stress in your child's life as possible. If the dynamics of your family life are generating too much hostility at home, seek marital or family counseling. If your child is lacking social skills, is overly fearful and anxious, or is having difficulty getting past some stressful event, arrange to have your child meet with a child specialist who can help your child learn the necessary coping, emotional or social skills.

Finally, as with so many childhood disorders, obesity is not something that can be overcome quickly or easily. In time, however, with patience, understanding and a realistic plan, you can succeed in helping your child adopt healthier behaviors and attitudes about food, eating and exercise.

Visitor Comments: 11

(11)
Anonymous,
June 3, 2013 12:00 AM

I only know one thing for certain. Children, adolescents and young adults need to be secure in the knowledge that we parents love them for who they are, and not what they look like. The world is full of thin good looking people with high IQ's. Whether these people are mensch's is a different story.

(10)
Anonymous,
June 2, 2013 11:57 PM

My 22 year old DS developed a weight problem in high school after being thin as a young child. I'm concerned about his obesity because diabetes runs in the family. I wish I had a definitive solution to this problem! So far I've been clutching at straws.

(9)
Anonymous,
June 18, 2005 12:00 AM

I was a thin child, but in my late teens and now thru my late 20s have batteled the gaining of over a hundred extra pounds. After years of searching, and pleading with doctors (also include yelling, screaming and fit throwing) have discovered that I have a complex set of thyroid and adrenal problems.
It took a decade but I finally found a few doctors who took into account my Judaism. Why is this important? Jews have a much higher incidence of problems such as this due most likely to genetics. If a child is suffering weight issues their parents should have them thoroughly evaluated by a doctor who has an understanding of issues that plague Jewish health. Jews are more likely to have Congenital Adrenal Hyperplasia (CAH), THyroid abnormailities, Poly Cystic OVarian Syndrome and other diseases that lead to obesity as well as infertility and diabetes.
I know far too many JEwish women who at a young age (like myself) already know that we have close to zero chance of ever having natural children. This is not due simply to the disease but due to the fact that our health complaints are ignored. Most doctors see only the weight gain and send us off to Weight Watchers. It is not until the problems get out of hand that they are willing to really listen and consider some treatment other than eating less, excercising more.
AMong other things a recent study of obese women with breast cancer reaveled that they get less potent doses of necessary medications and are often diagnosed later.
And many obese individuals who cannot trace their obesity back to actually overeating and a sedentary lifestyle often resort to eating disorders as a method to control their weight. I personally took the advice to eat less to somewhat of an extreme. This causes further damage to the system and can aggravate existing health problems.
I hope in the future that fewer Jewish women have to spend years in frustration while becoming even more overwieght and more ill.

(8)
MESA,
June 16, 2005 12:00 AM

too much of the not-so-good, not enough of the good

Obviously, it's important for children to learn, but they spend long days in school, and then they have homework that keeps them busy, so there's so little time just to get exercise. And schools do not often provide enough physical education. Until I reached high school, physical education consisted of going to the school gym and playing some kind of game in which we still didn't move around much.

One thing I recommend to parents is that they should find a good form of exercise that they enjoy and then invite (not force) their children to join them in it. If the child would rather do some other exercise, try to encourage it.

I myself do a lot of yoga, and I love it. It would be nice if my children joined me in it when they're old enough, but if they'd rather jog or do gymnastics, that's fine.

(7)
Anonymous,
June 15, 2005 12:00 AM

Parents should refocus their own attitudes!

As a woman who as a child battled my weight to the point that I developed an eating disorder (which I then battled for over 15 years!) I will say that the biggest influence on me was what went on behaviorally and verbally inside my childhood home! My father "jokingly" berated my mother about her weight calling her names ('chubby wubby" ) . My mom would skip meals,, or would eat differently than us if she was on some time of weight loss system or other regimen with prepackaged food. As far back as I can remember, she would go from diet to diet and her weight go up and down,

Ironically, today, (after having suffered anorexia and bulimia for many years!) I am one of the healthiest women I know as far as my attitude about weight! I am the mother or three healthy children of normal weight. I do not own a scale. I could not tell you what I weigh, and I don't care. It's nuts what a number can do do a person's self esteem, and from my experience, it's just not worth it. As far as my children go, I am very careful to do the following:

1. I never talk about weight unless responding to a specific question asked by one of my children.
(I've noticed that these questions usually result from things other kids have said, which I guess they heard from a parent). An example which I heard recently is: "Mommy do carbohydrates make you fat?"

2. I always eat meals with my kids and we all eat the same foods.

3. I don't label foods as "good" or "bad".

3. I don't overexercise, or talk about exercise in any way other than it is a way for people to keep their bodies healthy... (Much in the same way eating nutritiously keeps our bodies healthy.)

4. I never use food as a reward or punishment. (ie. " if you are a good boy, you can have two cookies instead of one!")
I am amazed at how many parents do this and then wonder why their kids fixate on sweets!

5. I never make my kids clean their plates or eat foods they don't want to eat. It's true what they say about kids naturally gravitating toward foods and quantities that they need. I always know when mine are going through a growth spurt: THAT'S when they eat all their chicken and even ask for seconds!

6. I spend a lot of time outdoors- gardening, taking walks, appreciating nature with my kids. Sharing the wonders of our world and the genius of G-d's plan, including the smorgasbord of natural and miraculous food he has provided for us. (most fruits and vegetables grow in single servings and are packaged to go!)

I hope these suggestions work for you as they have for me!

(6)
Konrad Keller,
June 15, 2005 12:00 AM

Finally - Judiasm empraces sport and healthy lifestyle

Through my life I have been amazed how droconian Jewish people's attitudes are towards sport and healthy eating. As the torah clearly states we must do everything in our power to embrace and prolong our lifespans, it has shocked me to find so many religious Jews never participating in sport or outdoor activities. Some have even comdemned sport saying its a waste of time when 'you could be learning'. If Hashem wanted us just to learn 24hrs a day he wouldnt of created us with legs, arms and muscles. Life is a balance and unfortunately alot of Jews get this wrong.

(5)
Anonymous,
June 14, 2005 12:00 AM

I agree with the comment about day-schools and shul. One of my children developed a weight problem in 4th grade and we didn't know why. Turns out he was being rewarded *almost daily* with both packages of potato chips and cans of soda by his rebbe!!!! He was becoming a masmid, a diligent student, but a chubby one at that. We had to invoke the help of the school nurse to put the brakes the 'nosherie' at school.
Add to that the weekly lavish shul kiddushes, shalosh shudas, birthday parties, the 'candy man', near weekly class celebrations - dayenu -- enough! It's hard enough to live in a 'world of plenty' and stay healthy, but this atmosphere doesn't help.

(4)
Anonymous,
June 12, 2005 12:00 AM

true, but...

Everything Dr. Wikler wrote is true, but I'd like to add one more thing.
Sometimes, to praise a child for losing weight or foregoing dessert backfires. As Dr. Wikler wrote in reference to another point in the article, you are then focusing on the child's weight more than he/she is. The child may not WANT you to recognize the weight loss. He/she wants to be skinny automatically, and is not looking for minor recognitions or fake flattery.
If you feel the need to comment, DON'T say it in public, don't exagerate (you look sooooo skinny!) and always attach it to another compliment unrelated to weight loss.
That, I feel, is the most effective action for a parent to take.
Believe me, I speak from my own experiences as an overweight child, and as an adult who is still overweight.

(3)
Moka Gérard,
June 12, 2005 12:00 AM

Public Health

Dear,
Obesity is now, the very public health problem of all family in world.Dr Meir Wikler as well explaimed the causes and different solutions.
Well showed!

Gérard-MOKA
Belgium

(2)
Anonymous,
June 12, 2005 12:00 AM

Too Much Candy

As a teacher in a Jewish Day School I have to say how appalled I am at times with the amount of candy that children receive in shuls and even at school. I feel like I am fighting an uphill battle. Adults need to work together to help the children develop healthy lifestyles.

It must be a frustrating and neverending battle for parents whose efforts are curtailed by well-meaning others in the community who think that constantly giving out sweets is fine.

(1)
Chaim B. Colen, M.D.,
June 12, 2005 12:00 AM

Childhood Obesity

The facts that Dr. Wikler expresses in this article are true, and having been raised in an orthodox evironment, I would like to summarize that there are three basic problems that promulgate the orthodox scene.
1- Little or no exercise (I'm referring to strenuous exercise for a cardiovascular workout! 40 minutes minimum)
2- NOshing! (I remember being told prior to my wedding that the most important table was the "noshing table"(dessert table) - We didn't "listen" and had a large assortment of fruits and very few of th other more traditional sugary desserts.
3- No Anti-Obesity programs (maybe the rav can incorporate this topic into his mussar (lecture), etc...?)After all, keeping our bodies healthy is a vital mitzah (commandment)

I live in rural Montana where the Cholov Yisrael milk is difficult to obtain and very expensive. So I drink regular milk. What is your view on this?

The Aish Rabbi Replies:

Jewish law requires that there be rabbinic supervision during the milking process to ensure that the milk comes from a kosher animal. In the United States, many people rely on the Department of Agriculture's regulations and controls as sufficiently stringent to fulfill the rabbinic requirement for supervision.

Most of the major Kashrut organizations in the United States rely on this as well. You will therefore find many kosher products in America certified with a 'D' next to the kosher symbol. Such products – unless otherwise specified on the label – are not Cholov Yisrael and are assumed kosher based on the DOA's guarantee.

There are many, however, do not rely on this, and will eat only dairy products that are designated as Cholov Yisrael (literally, "Jewish milk"). This is particularly true in large Jewish communities, where Cholov Yisrael is widely available.

Rabbi Moshe Feinstein wrote that under limited conditions, such as an institution which consumes a lot of milk and Cholov Yisrael is generally unavailable or especially expensive, American milk is acceptable, as the government supervision is adequate to prevent non-kosher ingredients from being added.

It should be added that the above only applies to milk itself, which is marketed as pure cow's milk. All other dairy products, such as cheeses and butter, may contain non-kosher ingredients and always require kosher certification. In addition, Rabbi Feinstein's ruling applies only in the United States, where government regulations are considered reliable. In other parts of the world, including Europe, Cholov Yisrael is a requirement.

There are additional esoteric reasons for being stringent regarding Cholov Yisrael, and because of this it is generally advisable to consume only Cholov Yisroel dairy foods.

In 1889, 800 Jews arrived in Buenos Aires, marking the birth of the modern Jewish community in Argentina. These immigrants were fleeing poverty and pogroms in Russia, and moved to Argentina because of its open door policy of immigration. By 1920, more than 150,000 Jews were living in Argentina. Juan Peron's rise to power in 1946 was an ominous sign, as he was a Nazi sympathizer with fascist leanings. Peron halted Jewish immigration to Argentina, introduced mandatory Catholic religious instruction in public schools, and allowed Argentina to become a haven for fleeing Nazis. (In 1960, Israeli agents abducted Adolf Eichmann from a Buenos Aires suburb.) Today, Argentina has the largest Jewish community in Latin America with 250,000, though terror attacks have prompted many young people to emigrate. In 1992, the Israeli Embassy in Buenos Aires was bombed, killing 32 people. In 1994, the Jewish community headquarters in Buenos Aires was bombed, killing 85 people. The perpetrators have never been apprehended.

Be aware of what situations and behaviors give you pleasure. When you feel excessively sad and cannot change your attitude, make a conscious effort to take some action that might alleviate your sadness.

If you anticipate feeling sad, prepare a list of things that might make you feel better. It could be talking to a specific enthusiastic individual, running, taking a walk in a quiet area, looking at pictures of family, listening to music, or reading inspiring words.

While our attitude is a major factor in sadness, lack of positive external situations and events play an important role in how we feel.

[If a criminal has been executed by hanging] his body may not remain suspended overnight ... because it is an insult to God (Deuteronomy 21:23).

Rashi explains that since man was created in the image of God, anything that disparages man is disparaging God as well.

Chilul Hashem, bringing disgrace to the Divine Name, is one of the greatest sins in the Torah. The opposite of chilul Hashem is kiddush Hashem, sanctifying the Divine Name. While this topic has several dimensions to it, there is a living kiddush Hashem which occurs when a Jew behaves in a manner that merits the respect and admiration of other people, who thereby respect the Torah of Israel.

What is chilul Hashem? One Talmudic author stated, "It is when I buy meat from the butcher and delay paying him" (Yoma 86a). To cause someone to say that a Torah scholar is anything less than scrupulous in meeting his obligations is to cause people to lose respect for the Torah.

Suppose someone offers us a business deal of questionable legality. Is the personal gain worth the possible dishonor that we bring not only upon ourselves, but on our nation? If our personal reputation is ours to handle in whatever way we please, shouldn't we handle the reputation of our nation and the God we represent with maximum care?

Jews have given so much, even their lives, for kiddush Hashem. Can we not forego a few dollars to avoid chilul Hashem?

Today I shall...

be scrupulous in all my transactions and relationships to avoid the possibility of bringing dishonor to my God and people.

With stories and insights,
Rabbi Twerski's new book Twerski on Machzor makes Rosh Hashanah prayers more meaningful. Click here to order...